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Updated: Dec 22, 2025
Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
Published on: May 8, 2018
Stereotactic body radiotherapy (SBRT) can delay polymetastatic conversion in patients affected by liver
Luca Nicosia1, Francesco Cuccia2, Rosario Mazzola2
1Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, via Don Sempreboni 5, 37034, Verona, Negrar, Italy. lucanicosia.rg@gmail.com.
Purpose:
SBRT demonstrated to increase survival in oligometastatic patients. Nevertheless, little is known regarding the natural history of oligometastatic disease (OMD) and how SBRT may impact the transition to the polymetastatic disease (PMD).
Methods:
97 liver metastases in 61 oligometastatic patients were treated with SBRT. Twenty patients (33%) had synchronous oligometastases, 41 (67%) presented with metachronous oligometastases. Median number of treated metastases was 2 (range 1-5).
Results:
Median follow-up was 24 months. Median tPMC was 11 months (range 4-17 months). Median overall survival (OS) was 23 months (range 16-29 months). Cancer-specific survival predictive factors were having further OMD after SBRT (21 months versus 15 months; p = 0.00), and local control of treated metastases (27 months versus 18 months; p = 0.031). Median PFS was 7 months (range 4-12 months). Patients with 1 metastasis had longer median PFS as compared to those with 2-3 and 4-5 metastases (14.7 months versus 5.3 months versus 6.5 months; p = 0.041). At the last follow-up, 50/61 patients (82%) progressed, 16 of which (26.6%) again as oligometastatic and 34 (56%) as polymetastatic.
Conclusion:
In the setting of oligometastatic disease, SBRT is able to delay the transition to the PMD. A proportion of patients relapse as oligometastatic and can be eventually evaluated for a further SBRT course. Interestingly, those patients retain a survival benefit as compared to those who had PMD. Further studies are needed to explore the role of SBRT in OMD and to identify treatment strategies able to maintain the oligometastatic state.
Insights
Stereotactic body radiation therapy (SBRT) can delay the progression of oligometastatic disease (OMD) to polymetastatic disease (PMD). Some patients remain oligometastatic after SBRT and may benefit from further treatment.
Area of Science:
- Oncology
- Radiation Oncology
- Metastatic Disease Research
Background:
- Oligometastatic disease (OMD) is a transitional state between localized and polymetastatic disease (PMD).
- Stereotactic body radiation therapy (SBRT) has shown survival benefits in oligometastatic patients.
- The impact of SBRT on the natural history of OMD and its transition to PMD is not well understood.
Purpose of the Study:
- To investigate the natural history of oligometastatic liver disease after SBRT.
- To evaluate how SBRT affects the transition from oligometastatic disease (OMD) to polymetastatic disease (PMD).
- To identify factors influencing survival and progression in oligometastatic patients treated with SBRT.
Main Methods:
- Retrospective analysis of 61 oligometastatic patients with 97 liver metastases treated with SBRT.
- Assessment of synchronous vs. metachronous oligometastases and the number of treated metastases.
- Evaluation of overall survival (OS), cancer-specific survival, progression-free survival (PFS), and time to polymetastatic progression (tPMC).
Main Results:
- Median follow-up was 24 months; median OS was 23 months.
- Predictive factors for cancer-specific survival included further OMD after SBRT and local control of treated metastases.
- 82% of patients progressed, with 26.6% relapsing as oligometastatic and 56% as polymetastatic. Patients with one metastasis had longer PFS.
Conclusions:
- SBRT can delay the progression of oligometastatic disease to polymetastatic disease.
- A subset of patients may relapse as oligometastatic and could be candidates for further SBRT, retaining a survival benefit.
- Further research is needed to optimize SBRT strategies for maintaining the oligometastatic state.
